| NPI | 1821262353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RYAN SULLIVAN Owner,Member,Podiatrist 618-534-9193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001049A) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2009-07-27 |